WASHINGTON — Heavy drinking is one of the main ways we pile up the cost of health care for ourselves and our community. And while binge drinking has tapered off somewhat, heavy drinking is up across the country and in Dallas, Collin, Tarrant and Denton counties.

A recent report on alcohol use among developed nations includes some startling facts about booze:

Average alcohol consumption in Europe, North America and northeast Asia is roughly 10 liters of pure alcohol a year. That’s the equivalent of 100 bottles of wine, or 200 liters of beer (23.5 cases), for each person.

small graphic here Most of that consumption is accounted for by heavy drinkers. In the United States, 20 percent of drinkers account for three-fourths of alcohol consumption.

Just over 4 percent of U.S. deaths stem from alcohol use. (In Russia, it is an incredible 30.5 percent.) Worldwide, alcohol use is responsible for 3.3 million deaths — more than HIV, tuberculosis and violence combined.

Between 1990 and 2010, alcohol rose from the eighth- to the fifth-leading cause of death and disability worldwide.

“Tackling Harmful Alcohol Use,” released this month by the 34-nation Organization for Economic Cooperation and Development, doesn’t put an economic price on this. But it points to several studies estimating the economic consequences of alcohol, including a drop in productivity, increased violence and auto accidents.

In 2006, the U.S. Centers for Disease Control and Prevention estimated alcohol use cost the nation $223.5 billion, mostly for loss of productivity at work, but including $24.6 billion for direct medical expenses. Crime and justice costs were estimated at $38 billion.

A 2013 study in the National Journal of Preventive Medicine, using that earlier national estimate as a starting point, pegged the cost of alcohol abuse in Texas at $26.5 billion, or $703 for every resident.

Last week, federal officials reported a decline in teen binge drinking — having five drinks or more on one occasion within a month — between 2002 and 2013. It fell among adults as well.

But there are more heavy drinkers. Between 2005 and 2012, the number of heavy-drinking women in Collin County increased from 4.4 to 6.5 percent. Heavy drinking among the men of Dallas County increased from 7.8 to 8.9 percent.

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As many as one-third of American adults have alcohol use disorder at some point in their lives, the National Institutes of Health reported this month. The term is a medical diagnosis for problem drinking that causes mild to severe distress or harm.

“These findings underscore that alcohol problems are deeply entrenched and significantly undertreated in our society,” said George F. Koob, director of the National Institutes for Alcohol Abuse and Alcoholism.

The OECD study found that the most effective intervention to reduce alcohol abuse was between the drinker and his or her doctor. A doctor can outline the consequences and possible therapies for heavy drinking. Yet only 1 in 6 Americans with a drinking problem has talked with a doctor about it, the CDC reports.

The OECD report also found that alcohol taxes help discourage drinking. The United States has the lowest taxes on alcohol among the OECD’s 34 members, with an average of 14 cents per drink.